| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,220 |
7,016 |
$602K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
861 |
840 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
528 |
505 |
$51K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
294 |
284 |
$36K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
31 |
30 |
$34K |
| 59430 |
|
190 |
189 |
$31K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
301 |
271 |
$27K |
| 81002 |
|
6,633 |
5,034 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
229 |
216 |
$21K |
| 81025 |
|
2,251 |
2,124 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
679 |
641 |
$13K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
115 |
115 |
$13K |
| 99078 |
|
347 |
272 |
$10K |
| 59025 |
Fetal non-stress test |
264 |
177 |
$9K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
69 |
64 |
$7K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
198 |
190 |
$5K |
| 99080 |
|
13 |
13 |
$3K |
| 85018 |
|
587 |
558 |
$2K |
| 99071 |
|
417 |
391 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
25 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$877.06 |
| A4550 |
Surgical trays |
139 |
133 |
$847.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
24 |
$407.49 |
| 81003 |
|
133 |
132 |
$320.01 |
| 87210 |
|
26 |
25 |
$145.86 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
25 |
$93.60 |